Dr. 假面: So you take your child in for a well visit, but then you get a bill from your pediatrician's office. 大多数保险公司100%承保探病费用. 那你为什么会收到账单?
播音员: 让你的孩子健康快乐. 你现在进入的是"健康儿童专区. 辛迪·盖尔纳为您报道.
Dr. 假面: 当父母带着孩子来看望时, 他们通常希望儿科医生解决其他问题. 大发娱乐都有过这样的经历. 我会让父母来看望我, but then they'll also want me to refill medications or discuss headaches or stomach aches that their child's been having. And sometimes they want to discuss behavior concerns, evaluate for ADHD or depression. The problem is that insurance companies have very clear guidelines about what constitutes a preventive visit, which is how a well-child visit is billed versus what is billed under "E&M编码或评价与管理编码."
每家保险公司都有自己的指导方针, but there are some things that are standard across the board, and these are set based on recommendations from the American Academy of Pediatrics and the Affordable Care Act. 例如, 检查孩子的成长情况, 进行常规免疫接种, and checking developmental milestones are standard from birth to 5 years old. Screening for autism is now part of a well-child visit at ages 18 and 24 months. 视力检查三点开始, 一些血液检查也包括在内, 尤其是他们在检查身体状况的时候.
预防性检查不包括哪些内容? 这是一种急性或慢性疾病. If your child fell and you think they have a broken arm, 不包括. If your child takes several medications for asthma and you need refills for all of them, 不包括. If your child has depression or anxiety and you're wanting to discuss that and possibly have them started on medications, 不包括. 所有 these things that require your pediatrician to ask questions that are unrelated to preventative care, 来评估这些问题, 然后在需要的时候管理它们, 因此我提到了评估和管理编码, 不包括.
在这些情况下, your pediatrician can do one of a few things. Sometimes depending on what is being discussed and how long of an appointment is needed, we might ask you to come back and our staff will help you schedule an appointment to be seen as soon as possible. 如果你的儿科医生有时间, 他们可能会告诉你，他们可以解决这些其他问题, 他们应该告诉你如何编码. There are special modifiers that we use with coding to let the insurance companies know, “嘿, 大发娱乐知道这不是预防性检查的一部分, but we're trying to save the family from having to come back for a second visit and get everything done today.“如果大发娱乐不加修饰语, 这会让大发娱乐陷入麻烦的, because insurance companies don't like us to do more than what we're coding for.
也, 是儿科医生, 大发娱乐做了很多教育和评估在一个井的访问, 大发娱乐通常只有15分钟的预约. 所以如果大发娱乐花额外的时间解决额外的问题, 这不仅仅是挤占另一个病人的预约, 但是大发娱乐希望能得到额外工作的报酬. 尽管预防性护理非常重要, 尤其是对最年轻的病人, insurance companies pay very little to the pediatricians themselves. Pretty much we all knew that going into peds, but our little patients make the job so rewarding. 我知道我无法想象成为其他类型的医生. 还有什么医生能和婴儿一起玩, 和他们的病人谈论PokÈmon或超级英雄, 或者在大象的耳垢里寻找它们? 说真的，这是最好的练习方式.
现在, 大发娱乐知道有时候事情是不可避免的, like you have a well-child visit scheduled and your child wakes up with a fever of 102 or cold symptoms for instance. 在这些情况下, 这取决于你孩子的病情, we'll often address the acute issue and reschedule the well visit and also use that rescheduled well visit as a follow-up to make sure they're better. 如果只是轻微的病毒, 大发娱乐只是像往常一样进行一次油井访问, 因为大发娱乐知道孩子们每年会感染6到8种病毒, and it can be guaranteed that your child will have one at a well visit at some point. If it's something simple, I'll just document that we discussed supportive care.
另一个收到账单的原因, 这种情况不太常见, 你是不是太早给孩子做了一次健康检查. This is mainly for children over the age of 3 where insurance only covers one well visit per year. Some insurance policies consider one year from the date of the last well visit. 有些人认为每个政策年度一次. But for all insurances, they can only have one well-child visit per year if they're over 3. 所以如果你的孩子已经做了四年的检查, 例如, they have to be five before the next one and it has to pass that one year period.
也, 在安排油井访问时, make sure enough time has passed before the next set of vaccines if they're due for vaccines. An example of this is that there has to be at least six months between the first and second hepatitis A vaccines. Your child's pediatrician should be able to tell you exactly when they would be due for the next vaccine in the series.
So if you have any questions about when your child can be seen for a well visit or what all is covered in a well visit, please either check with your insurance company or talk to your pediatrician directly. 大发娱乐大多数人都知道规则.
播音员: 对医疗程序有疑问吗? 想了解更多关于健康状况的知识? 大于2,与大发娱乐的医生和专家进行了000次访谈, there's a pretty good chance you'll find what you want to know. 请登录thesoperadio查看.com.
